RESEARCH ARTICLE


Depression, Anxiety and Alcohol Abuse in a Gastroenterology Intensive Care Unit: Prevalence and Detection



Graça Cardoso1, 2, *, Joana Alexandre1, Alda Rosa3
1 Serviço de Psiquiatria, Hospital Fernando Fonseca, 2720-276 Amadora, Portugal
2 CEDOC, Departamento de Saúde Mental, Faculdade de Ciências Médicas, FCM, Universidade Nova de Lisboa, 1169-056 Lisboa, Portugal
3 Centro de Atendimento de Toxicodepentes (CAT), 2560-649 Torres Vedras, Portugal


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© Cardoso et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Serviço de Psiquiatria, Hospital Fernando Fonseca, 2720-276 Amadora, Portugal; Tel: +351 21 434 8272; Fax: +351 21 434 5566; E-mail: gracacardoso@gmail.com, joanaalexandre@gmail.com, alda_rosa@hotmail.com


Abstract

Objectives:

To assess depression, anxiety, and alcohol abuse in a Gastroenterology ICU, and the level of its detection by the staff.

Method:

All patients consecutively admitted to the ICU during a six-month period, 18 or above, and staying ≥ 24 hours, were assessed with the Hospital Anxiety and Depression Scale (HADS) and the CAGE. Doctors and nurses assessed the type and severity of patients’ morbidity. Data were analyzed with Student’s t-test, Pearson’s and Spearman’s correlations for ordinal variables, chi-square for nominal variables, and multiple logistic regression.

Results:

The 65 patients assessed had a mean age of 57, and were predominantly male (58.5%), married (72.3%), and retired (53.8%); 27.7% had a psychiatric history, 24.6% were on psychotropic drugs, and 32.3% had an alcohol intake above standards. Anxiety and depression HADS scores ≥ 8 were present in 29.2% and 35.4% of the patients, respectively; 20%, mainly men, scored positive on the CAGE. Women had significantly higher anxiety scores (=.012) than men but did not differ in depression. A psychiatric history was significantly associated with higher anxiety (p<.001) and depression (p=.007) scores, as well as being on psychotropic drugs regularly (p<.001; p=.03, respectively).

Doctors diagnosed somatic illness in 48.8%, and somatic illness with psychiatric co-morbidity in 51%; for nurses the rates were, respectively, 41.5% and 58.6%. Doctors’ and nurses’ detection of psychiatric disorders were significantly associated with the HADS anxiety scores (p=.013; p=.001, respectively), and doctor’s detection with depression (p=.046) scores. There were no significant associations between nurses’ detection of psychiatric disorders and depression, and between both professional groups detection and alcohol abuse.

Conclusion:

High prevalence of depression, anxiety, and alcohol abuse in Gastroenterology ICU was confirmed. However, the level of detection by the staff was low and mainly when anxiety symptoms were present.

Key Words: Depression, anxiety, alcohol abuse, detection, ICU.